No identity: One in five Aboriginal births unregistered in western Australia

Published today in The Australian and New Zealand Journal of Public Health, the finding, made by linking birth records from the WA Registry of Births, Deaths and Marriages to births recorded in the state's Midwives Notification System, revealed that 4,628 Aboriginal births to Aboriginal mothers weren't recorded in the Registry in the 16 years from 1996 to 2012.

While the Midwives Notification System records all births that were attended or had follow up care provided by a midwife or doctor, Birth Registrations records only include those children where the parent/s have lodged an application to register the birth. Registration records contain demographic information about the child and parents.

"In its current form, Western Australia's birth registration system doesn't ensure that all children have registered births," said the report's lead author, University of Sydney PhD student, Alison Gibberd.

"Australia is a signatory to several international conventions to ensure that all children have the right to be registered immediately after birth, but an unacceptably high number of Aboriginal children don't achieve this right."

The new report reveals that from 1996 to 2012, unregistered Aboriginal births were more common among mothers who were teenagers when they had their first child, and among those living in socioeconomically disadvantaged and remote areas. Aboriginal children born to mothers aged less than 16 years were five times more likely to be unregistered than those born to mothers aged 30 years and older.

Unregistered births were also more common among babies born in rural hospitals, when a mother smoked during pregnancy, or had an alcohol-related diagnosis near the time of the birth. Children born to mothers whose own birth was unregistered and who had no private health insurance were three times more likely to be unregistered.

"For most Australians, a birth certificate is the first documentary evidence of identity," said Aboriginal health leader and research supervisor, Professor Sandra Eades of Baker IDI Heart and Diabetes Institute. "Proof of identity and Australian citizenship are essential for many rights, including obtaining a passport, a driver's licence and opening bank accounts.

"However, a birth certificate can only be obtained once a birth is registered, and the births of many Australians, particularly Aboriginal Australians, are not registered when they are babies."

Low birth registration rates aren't limited to Western Australia. A recent Queensland study reported that 17 per cent of 2 to 4 year-old Aboriginal children did not have registered births.

The high number of unregistered births suggests Aboriginal families face major barriers registering the birth of newborns. In Western Australia, parents must lodge the necessary forms with the Registry of Births, Deaths and Marriages within 60 days of a child's birth. The relevant forms are supplied to parents soon after the birth of a child by hospital staff or a midwife. Registering a birth is free but a birth certificate currently costs AUD $47.

"Successfully completing the birth registration process requires a reasonable level of literacy and the practical means of returning the completed paperwork to the Registry of Births, Deaths and Marriages," said Alison Gibberd. "It also relies on parents recognising the value of birth registration, particularly if they cannot afford the cost of a birth certificate at that time."

What can be done to raise birth registrations among Aboriginal people?

"Since most births occur in hospitals, there is an opportunity for hospitals to provide a higher level of assistance to complete birth registration forms before the mother and child leave hospital," said Professor Eades, who heads Aboriginal health programs at Baker IDI Heart and Diabetes Institute.

Barbara Henry, CEO of Derbarl Yerrigan Health Service Inc, said the report highlights a need for better education about the benefits of birth registration and more support for new parents in navigating the relevant bureaucracy to achieve certification. "There are a number of very simple changes we could make to make it easier for new parents to register the birth of their child," said Ms Henry.

"We could look at streamlining the current system and providing additional support to new mothers to complete the birth registration paperwork before they leave hospital. It may also be possible to integrate administrative assistance for mothers through existing funded programs such as nurse home visits.

"Importantly, this report has surfaced an issue that causes disadvantage amongst Aboriginal people. Now that we understand the scope of the problem, we can turn our attention to raising community awareness and finding creative solutions."

The study reveals that registration rates have improved since 2006, particularly in remote areas. This may be due to an increasing focus on unregistered births in recent years. For example, several programs are run in remote Western Australia to assist Aboriginal people to obtain driver's licences (including the prerequisite birth certificate). Additionally, since 1 July 2007, parents could only receive the Baby Bonus, parental leave pay or family tax benefits if they declared that they had applied for the child's birth to be registered.

The study sample comprised all live births in Western Australia from 1980 to 2010, whose mothers were recorded as Aboriginal and/or Torres Strait Islander on their Midwives Notification System record. The birth of infants of 20 weeks or more gestation and/or 400 grams birth weight must be notified to the WA Department of Health by attending midwives or medical officers.